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Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim
Pedro J Greer1, David R Brown, Luther G Brewster
1P.J. Greer Jr is professor and chair, Department of Humanities, Health, and Society, and associate dean, Community Engagement, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0001-6682-8204. D.R. Brown is associate professor and chief, Division of Family and Community Medicine, and vice chair, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-5361-6664. L.G. Brewster is associate professor and chief, Division of Policy and Community Development, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0001-8067-3667. O.G. Lage is associate professor and vice chair, Education and Faculty Development, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-2121-4687. K.F. Esposito is professor, Department of Psychiatry and Behavioral Sciences, and associate dean, Curriculum and Medical Education, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-3988-235X. E.B. Whisenant is assistant professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-1100-1565. F.W. Anderson is assistant professor and medical director, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0003-4750-5236. N.K. Castellanos is assistant professor, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-4393-4191. T.A. Stefano is consultant, Department of Humanities, Health, and Society, Florida International University Herbert Wertheim College of Medicine, Miami, Florida; ORCID: http://orcid.org/0000-0002-6972-5873. J.A. Rock is professor, Department of Obstetrics and Gynecology, dean, Herbert Wertheim College of Medicine, and senior vice president, Health Affairs, Florida International University, Miami, Florida; ORCID: http://orcid.org/0000-0002-9970-8417.
Problem:
Despite medical advances, health disparities persist, resulting in medicine's renewed emphasis on the social determinants of health and calls for reform in medical education.
Approach:
The Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Herbert Wertheim College of Medicine provides a platform for the school's community-focused mission. NeighborhoodHELP emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care. NeighborhoodHELP is a required, longitudinal service-learning outreach program in which each medical student is assigned a household in a medically underserved community. Students, teamed with learners from other professional schools, provide social and clinical services to their household for three years. Here the authors describe the program's engagement approach, logistics, and educational goals and structure.
Outcomes:
During the first six years of NeighborhoodHELP (September 2010-August 2016), 1,470 interprofessional students conducted 7,452 visits to 848 households with, collectively, 2,252 members. From August 2012, when mobile health centers were added to the program, through August 2016, students saw a total of 1,021 household members through 7,207 mobile health center visits. Throughout this time, households received a variety of free health and social services (e.g., legal aid, tutoring). Compared with peers from other schools, graduating medical students reported more experience with clinical interprofessional education and health disparities. Surveyed residency program directors rated graduates highly for their cultural sensitivity, teamwork, and accountability.
Next Steps:
Faculty and administrators are focusing on social accountability curriculum integration, systems for assessing and tracking relevant educational and household outcomes, and policy analysis.
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